Provider Demographics
NPI:1558384776
Name:MADISON, CHRISTOPHER ERIC (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ERIC
Last Name:MADISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 WILLIAM HILTON PKWY
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-2497
Mailing Address - Country:US
Mailing Address - Phone:843-738-4800
Mailing Address - Fax:843-738-4801
Practice Address - Street 1:460 WILLIAM HILTON PKWY
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-2497
Practice Address - Country:US
Practice Address - Phone:843-738-4800
Practice Address - Fax:843-738-4801
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30671207Q00000X
SC12902207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1558384776Medicaid
NC53707OtherNCBCBS
NC8953707Medicaid
SC129024Medicaid
NC080179683Medicare PIN
SC129024Medicaid
NC204159HMedicare PIN
C89571Medicare UPIN
NC204159FMedicare PIN
NC53707OtherNCBCBS
NC1558384776Medicaid